外伤性晶状体脱位合并周边隐匿性视网膜病变的临床特征及预后分析  

Clinical features and prognosis of traumatic lens dislocation complicated with peripheral occult retinopathy

作　　者：付鹏[1] 沈念[1] 黄艳玲 杨水平 万小波[1] Fu Peng;Shen Nian;Huang Yanling;Yang Shuiping;Wan Xiaobo(Department of Ophthalmology,Liuzhou People's Hospital,Liuzhou 545006,China)

机构地区：[1]柳州市人民医院眼科,广西柳州545006

出　　处：《中华临床医师杂志（电子版）》2022年第6期536-540,共5页Chinese Journal of Clinicians(Electronic Edition)

基　　金：广西壮族自治区卫健委自筹经费项目(Z20170655);柳州市科技计划项目(2020NBAB0832)。

摘　　要：目的观察分析眼球钝挫伤合并外伤性晶状体脱位患者周边隐匿性视网膜病变的临床特点及预后。方法本研究纳入2013年1月至2020年1月在柳州市人民医院眼科住院诊断为眼球钝挫伤合并外伤性晶状体脱位,并行23G微创玻璃体切割联合白内障摘除手术的72例(72眼)患者。根据裂隙灯和超声生物显微镜(UBM)检查,将患者分为晶状体不全脱位组和全脱位组,详细记录2组患者的术中周边视网膜病变情况,并分析其临床特征及疗效。结果眼球钝挫伤合并外伤性晶状体脱位患者中有周边隐匿性视网膜病变的占72.22%,其中晶状体不全脱位组发生率高达80.95%,显著大于晶状体全脱位组的60.00%(P<0.05)。2组患者的周边隐匿性视网膜病变均以隐匿性视网膜裂孔、变性和出血为最常见。所有患者术后视网膜情况稳定,视力预后较好。结论眼球钝挫伤合并外伤性晶状体脱位患者常出现周边隐匿性视网膜病变,最常见的是视网膜裂孔、出血、变性。23G微创玻璃体切割联合白内障摘除手术是有效治疗手段,具有创伤小、并发症少的优势。Objective To investigate the clinical features and prognosis of peripheral occult retinopathy in patients with blunt eye contusion and traumatic lens dislocation.Methods This study included 72 patients(72 eyes)with ocular contusion combined with traumatic lens dislocation.They received 23G minimally invasive vitrectomy combined with cataract extraction from January 2013 to January 2020 at Liuzhou People's Hospital.According to slit lamp and ultrasound biomicroscopic(UBM)examination results,the patients were divided into either an incomplete dislocation group or a total dislocation group.Peripheral retinopathy in the two groups was intraoperatively recorded in detail,and its clinical characteristics and curative effect were analyzed.Results The majority(72.22%)of patients with obtuse eyeball contusion combined with traumatic lens dislocation had peripheral occult retinopathy.The prevalence of peripheral occult retinopathy in the lens incomplete dislocation group was as high as 80.95%,which was significantly higher than that in the lens total dislocation group(60.00%;P<0.05).Occult retinal tear,retinal degeneration,and retinal hemorrhage were the most common peripheral occult retinopathies in both groups.The postoperative retinal condition of all patients was stable with a good visual prognosis.Conclusion Peripheral occult retinopathy often occurs in patients with ocular contusion combined with traumatic lens dislocation.The most common peripheral occult retinopathies are retinal tear,hemorrhage,and pathological degeneration.23G minimally invasive vitrectomy combined with cataract extraction is an effective treatment with the advantages of less trauma and fewer complications.

关 键 词：外伤性晶状体脱位 23G微创玻璃体切割术 白内障摘除术 周边隐匿性视网膜病变 

分 类 号：R774.1[医药卫生—眼科]